Background: Heart disease is the leading cause of death in the United States. 1 in 3 women visit the ER with cardiovascular related health events, and they often experience longer wait times, less emergent care and worse cardiovascular outcomes due to atypical symptoms such as neck pain and dizziness upon presentation to the ED. Understanding risk factors, such as cardiovascular health during pregnancy and in the fourth trimester (post-partum period), can help identify at-risk patients earlier, and help develop comprehensive guidelines for screening women before cardiovascular morbidity occurs.

Methods: A cross-sectional survey was administered to 106 women at an outpatient cardiology clinic. Participants completed a questionnaire that recorded details about their pregnancy and cardiovascular history, in addition to age at first pregnancy, parity, pregnancy complications/loss, and pre-pregnancy and postpartum cardiovascular diagnoses. Rates of hypertension were then stratified by race and educational status of patients. Educational status was stratified as some high school, high school diploma/GED, associate's degree, some college but no degree, bachelor’s degree, and graduate or professional degree (MA, MS, MBA, PhD, JD, MD, DDS etc.). Race was categorized as White or Caucasian, Black or African, Asian, Other, or Prefer Not to Say.

Results: 100% of study participants who reported hypertension during pregnancy developed hypertension later in life, regardless of demographic factors. There was no significant increase in post-pregnancy hypertension rates in women with lower educational attainment (=1.83, df=5, p=0.87).  There was also no significant increase in post-pregnancy hypertension rates between patients of different races (=4.39, df=4, p=0.36).

Conclusion: This pilot study highlights the need to aggressively screen all women who have been pregnant for hypertension and cardiovascular risk, regardless of demographic factors. Despite previous studies demonstrating that race and lower educational attainment can increase risk of cardiovascular disease, our data did not show a significant impact on risk. By developing and implementing aggressive screening guidelines, cardiovascular related mortality and morbidity in women due to delayed diagnosis and treatment can be significantly decreased.

Swati L. Narayan is a medical student at Rutgers Robert Wood Johnson Medical School. She graduated from Amherst College with a bachelor’s degree in biology. Prior to medical school, she worked in clinical research at Dana Farber Cancer Institute and Boston Children’s Hospital, which inspired her to continue engaging in clinical research during her time in medical school. Her research interests South Asian cardiovascular health, autoimmune disorders and women’s health.